BACKGROUND: Among adults with hypertension, obesity independently contributes to cardiovascular disease. Weight loss and hypertension control are critical to reduce cardiovascular events. The purpose of this study was to evaluate rates and predictors of achieving weight loss among adults who achieved hypertension control within 1 year of developing incident hypertension. METHODS: Retrospective electronic health record analysis was performed of ≥18 year olds with a body mass index ≥30.0kg/m2, who received regular primary care from 2008 to 2011 and achieved hypertension control. Exclusions were less than 60 days follow-up, prior hypertension diagnosis, prior antihypertensive prescription, or pregnancy. The primary outcome was clinically significant weight loss (≥5kg); the secondary outcome was modest (2.0-4.9kg) weight loss. Multinomial logistic regression identified predictors of achieving weight loss (≥5 or 2.0-4.9kg) compared to no significant weight loss (<2kg). RESULTS: Of the 2,906 obese patients who achieved hypertension control, 72% (n = 2,089) did not achieve at least 2.0kg weight loss. Overall, 12% (n = 351) achieved ≥5kg weight loss. Young adults (18-39 year olds; odds ratio (OR): 2.47, 95% confidence interval (CI): 1.63-3.47), middle-aged adults (40-59 year olds; OR: 2.32, 95% CI: 1.59-3.37), and patients prescribed antihypertensive medication (OR: 1.37, 95% CI: 1.07-1.76) were more likely to achieve clinically significant weight loss and hypertension control. Age remained a significant predictor for 2.0-4.9kg weight loss. CONCLUSIONS: Despite achieving hypertension control, the majority of obese patients did not achieve clinically significant weight loss. Effective weight loss interventions with dedicated hypertension treatment are needed to decrease cardiovascular events in this high-risk population.
Bibliographical noteFunding Information:
This original research was supported by the Clinical and Translational Science Award program, previously through the National Center for Research Resources (NCRR - UL1RR025011) and now by the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) under award number U54TR000021. H.M.J. is supported by the National Heart, Lung, and Blood Institute of the NIH (K23HL112907) and also by the University of Wisconsin (UW) Centennial Scholars Program of the University of Wisconsin School of Medicine and Public Health. C.M.B. is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH (K23AR062381). N.P. is supported by the National Institute on Aging of the NIH (K08AG029527).
© 2016 American Journal of Hypertension, Ltd. All rights reserved.
- blood pressure
- primary care
- weight management